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Table 1 Laboratory and imaging tests performed after development of acral ischemia

From: Acral vascular necrosis associated with immune-check point inhibitors: case report with literature review

  Tests Performed Results
Infection CBC, CRP Blood cultures Echocardiography HBV, HCV Normal Negative No vegetation or myxoma Negative
Hypercoagulable state Protein C Protein S Anti- thrombin 3 Platelet PT/aPTT/INT 131% (Normal) 73% (Normal) Normal 280 10 × 3/uL (Normal) Normal
Lymphoproliferative disease Kappa/Lambda Ratio Beta-2 microglobulin (B2M) LDH SPEP/IFE 1.37 (Normal) 3 mg/L (Mildly elevated) 138 U/L (Normal) Normal
Tumor invasion CT Chest CT Angiography No invasion of sympathetic nervous plexus No vascular occlusion, saccular aneurysm or stenosis up to the palmar arch arteries
Autoimmune and inflammatory disease / Thromboangiitis obliterans ANA ESR CH50 ANCA-c, ANCA-p Cryoglobulin APL ab, Anti-Scl-70 Ab, Anti-dsDNA ab, Anti-U1 RNP Ab, Anti-Sm ab, Anti-Ro/SSA ab Nailfold videocapillaroscopy Skin biopsy 1:80 Homogeneous 70 mm/hr 170 CAE Units (elevated) (Acute phase reactant) Normal Negative (Normal) Not performed Not performed Not performed
  1. Ab: antibodies, APL: antiphospholipid, Anti-Scl-70: topoisomerase I, ANCA-c: Central anti-neutrophil cytoplasmic antibodies, ANCA-p: perinuclear anti- neutrophil cytoplasmic antibodies, Anti-Sm: anti smith antibodies, Anti-Ro/SSA: anti sjögren’s syndrome related antigen A, SPEP: serum protein electrophoresis, IFE: immunofixation electrophoresis